Ophthalmology: Eye Specialist

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What is Ophthalmology?

Ophthalmology is a branch of medicine that specializes in the diagnosis and treatment of eye disorders. Ophthalmologists are trained both medically and surgically to diagnose and treat a variety of eye problems. This includes:

Eye Examinations

Diagnosing and Treating Eye Conditions

Prescribing Glasses or Contact Lenses

Performing Eye Surgery (cataracts, LASIK, PRK, etc.)

The most serious eye diseases include macular degeneration, diabetic retinopathy and glaucoma and these conditions require an eye specialist.

Medical training required to be an ophthalmologist:

After completing medical school, graduates must complete an ophthalmology residency that lasts a minimum of 4 years before they can legally become an ophthalmologist. They can then opt to continue their training to become a specialist in a specific ophthalmology sub-specialty such as:

Pediatrics

Retinal and Vitreous Diseases

Cornea and External Diseases

Refractive Surgery

Glaucoma

Oculoplastics

Ocular oncology

Neuro

How to find the best Ophthalmologist:

When trying to find the best eye clinic it’s important to consider a variety of different factors:

Experience – Find out the number of years your ophthalmologist has been practicing and the number of successful procedures they have completed. For example, if you’ve been diagnosed with cataracts, ask your ophthalmologist how many successful cataract procedures they’ve performed. You can also ask how many eye doctors have chosen them for their own eye surgery.

Training – Find out if your ophthalmologist has received training in a certain sub-specialty. Especially if you’ve been diagnosed with a particular disorder. For example, if you’ve been diagnosed with wet macular degeneration, make sure your ophthalmologist specializes in retinal diseases.

Professional accreditations – Find out if your ophthalmologist has received awards from any ophthalmologic societies or if they’ve published any papers in scientific journals.

Frequently Asked Questions About Ophthalmology:

What is the anatomy of the eye?

The eye works much like a camera; light is reflected by the cornea, the clear outer surface in front of the eye, into the pupil, the opening in front of the iris. The iris controls the amount of light that reaches the back of the eye by narrowing the diameter of the pupil—almost like the aperture of a camera. Behind the pupil is a lens, which works to focus light clearly onto the retina in the back of the eye. Once the light has been focused onto the light-sensitive surface retina, the image is translated into images by the optic nerve.

What’s an eye exam with an ophthalmologist like?

An eye exam with an ophthalmologist should be simple, comfortable, and last around 45 to 90 minutes. In the first part of your eye exam with your ophthalmologist, your doctor will ask you about your complete medical history. You and your ophthalmologist will go over your overall health, your vision, your family’s history with eye diseases, what medications you’re on, and what type of corrective lenses you use, if any. You will then undergo a standard eye exam to test for refractive problems. You’ll be asked to read an eye chart at various distances and asked to identify different sets of letters. Your near and far vision will be tested. Your ophthalmologist can also perform a refraction assessment, either through a computerized refractor or through retinoscopy. A refractive error is when light waves that pass through your cornea and lens don’t bend correctly (which then causes vision problems like nearsightedness, farsightedness and astigmatism), so a refraction assessment can measure your refractive error by measuring how well light reflects onto the retina.

To check your need for corrective lenses and refine the findings from the previous test, your ophthalmologist will ask you to view an eye chart through a phoroptor, a device that uses different lenses to check your ability to see different objects clearly (this is the device you sit in front of in the ubiquitous “better, or worse” test.)

Sometimes, an ophthalmologist will test how well your pupils react to stimulus by shining a bright light into your pupils. They will test whether your pupils properly constrict to light stimulus.

An ophthalmologist might also test for loss of side vision—a symptom for glaucoma. They can also test for eye movement through an ocular motility test. Because eye movement is a reflection of proper eye alignment and ocular muscle function, a common test is to see how quickly the eye darts around and how well it can track objects.

Another test is the slit lamp examination; in this test, your ophthalmologist might use eye drops to apply a dye into the eye. Then, a microscope called a slit lamp is placed in front of your eye and your ophthalmologist will examine the eyelids, the cornea, iris, lens, and the fluid chamber in between the cornea and the iris. The fluorescent dye will help the ophthalmologist determine if there are any damaged cells on the front of the eye, like a cataract or any scars and scratches.

Your doctor will also test your color vision using a chart filled with a pattern of multicolored dots.

How Does an Ophthalmologist Screen for Glaucoma?

Some tests performed by your ophthalmologist, like tonometry, might require the numbing of your eye. Tonometry measures the pressure inside your eye because fluid pressure that’s higher than normal might be a sign of glaucoma. For a tonometry test, your ophthalmologist will send a quick burst of air into your eye. Another tonometry test flattens a small part of your cornea by gently pressing the tip of a device onto the surface of your cornea. Before this test, you’ll be given eyedrops with a fluorescent dye.

What Happens in a Retinal Examination?

To look for possible diseases or abnormalities, ophthalmologists perform various types of retinal examinations. Before your retinal examination, your ophthalmologist will dilate your pupils with eyedrops so that they don’t contract when they shine a light into the eye and they can get a clear view of the retina.

Additional tests that an ophthalmologist can perform can include specialized imaging techniques like oct (optical coherence tomography) or a funduscopy. With an OCT, patients will have their dilated eyes scanned by a camera. The OCT will look at the optic nerve and look for any signs of macular holes and swelling. Fundus photos take photographs of the retina through a computer and a camera, allowing the ophthalmologist to compare the state of the blood vessels and optic nerve over time.

One additional test your ophthalmologist might perform is fluorescien angiography. With Fluorescein angiography, a dye will be injected into the arm so that it can travel throughout the blood stream and into the blood vessels in the retina. A camera will then take pictures of the retina to locate any vascular abnormalities—a possible sign of macular degeneration and other conditions.

After the pupils have been dilated, patients will experience some sensitivity and blurriness for a few hours. It’s highly recommended that patients don’t drive themselves home immediately after their pupils have been dilated.

When should a child’s eyes be examined by an ophthalmologist?

It’s actually recommended that newborns have their eyes checked before they’re discharged from the hospital. After that, a pediatrician can refer the patient to an ophthalmologist if possible vision problems are suspected. Signs of vision problems in children include:

Constantly rubbing the eyes

Light sensitivity

Drooping lids

Crossed eyes

Constantly tilting the head

Covering or closing one eye

Inability to follow objects

Difficulty reading or seeing things up close

When should an adult’s eyes be examined by an ophthalmologist?

It’s highly recommended that adult patients have their eyes examined on a regular basis. From ages 20-39, patients should have their eyes checked by an ophthalmologist every three to five years. By the time they’re 40, it’s highly recommended that patients get a baseline eye examination. Then from the ages of 40-65, patients should get checked every two to four years, while patients 65 and older should have an eye exam from an ophthalmologist every one or two years. Because your risk of developing eye diseases increases as you age, many ophthalmology organizations and ophthalmologists recommend that patients increase the frequency of their eye exams as they get older.

However, if you have a history of eye diseases, it’s important that you have your eyes checked by an ophthalmologist with greater regularity. If you have a risk factor for developing an eye disease like having a family history of eye disease or if you have diabetes or high blood pressure, it’s essential that you also have your eyes check much more frequently than normal.

Do eye exams hurt?

No, eye exams are not painful. In the case that the ophthalmologist has to perform a tonometry test, your eye will be numbed to make sure the patient is as comfortable as possible.

What’s the difference between an ophthalmologist and an optometrist?

In addition to their training, an ophthalmologist and an optometrist differ in what they can and can’t treat. Generally speaking, an ophthalmologist can diagnose and treat eye diseases and perform eye surgeries, like refractive eye surgery.

An optometrist is a licensed eye doctor, and they primarily diagnose vision problems and prescribe eyeglasses and contact lenses. Optometrists are also licensed to prescribe treatments for certain eye diseases like eye infections. Oftentimes, an optometrist and ophthalmologist will work together in an arrangement called co-management. An ophthalmologist will treat the patient medically or surgically, and the optometrist will monitor the patient’s post-operative recovery.

I have an eye condition, should I see an ophthalmologist or an optometrist?

If you already have a medical eye problem like glaucoma or macular degeneration, it’s important to get care from a specially-trained ophthalmologist so that they can monitor and treat your eye condition.